ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

OBJECTIVE To investigate the efficacy and safety of tirofiban for early neurological deterioration in patients with acute ischemic stroke. METHODS A total of 126 patients with early neurological deterioration of acute ischemic stroke who were admitted to the Department of Neurology， Heji Hospital Affiliated to Changzhi Medical College from January 2022 to December 2023 were selected and divided into observation group and control group according to random number table method， with 63 cases in each group. All patients received standardized treatment such as lipid-lowering and blood pressure-lowering therapy. Based on the standard treatment， patients in the control group additionally took Aspirin enteric-coated tablets 100 mg+Clopidogrel bisulfate tablets 75 mg orally （once a day， for 14 consecutive days）. The patients in the observation group received Tirofiban hydrochloride and sodium chloride injection based on the standardized treatment [first intravenous infusion of 0.40 μg/（kg·min） for 30 min， and then continuous intravenous infusion of 0.10 μg/（kg·min） for 47.5 h]； subsequently， patients were given Aspirin enteric-coated tablets （100 mg） and Clopidogrel bisulfate tablets （75 mg） once a day for 14 consecutive days. The clinical efficacy， the National Institutes of Health Stroke Scale （NIHSS） score， modified Rankin Scale （mRS） score， and hemorheological indexes before and after treatment were compared between the two groups， and the adverse reactions were recorded. RESULTS The total effective rate （87.30%） of the observation group was significantly higher than that of the control group （71.43%） （P＜0.05）. NIHSS scores of the two groups at 1st， 7th and 14th day after treatment， the mRS score at 90th day after treatment， and the platelet aggregation rate， whole blood viscosity， plasma viscosity and fibrinogen at 14th day after treatment were significantly lower than those before treatment in the same group， and the observation group was significantly lower than the control group at the same period （P＜0.05）. The total incidences of adverse reactions such as nausea， headache， fever， gastrointestinal bleeding， oral and nasal mucosal bleeding and thrombocytopenia in both groups of patients were 28.57% respectively， with no statistically significant difference （P＞0.05）. CONCLUSIONS For patients with early neurological deterioration in acute ischemic stroke， the addition of tirofiban can accelerate the recovery of neurological function， improve blood hyperviscosity and platelet aggregation， and improve the prognosis of patients with good safety.

Objective:To evaluate the histocompatibility and biomechanical properties of domestically produced abdominal wall segment polylactic acid absorbable microhook urethral sling in an animal model.Methods:Twenty four rabbits were divided into two groups: polylactic acid microhook sling group ( n=12) and TVT ABBREVO sling group ( n=12). Segments of the slings (abdominal wall portion and urethral portion) were implanted into the rabbit′s abdominal wall and the vesicovaginal space, respectively. Specimens were harvested via euthanasia at postoperative 0 day ( n=3 per group), 4 weeks ( n=3 per group) and 12 weeks ( n=6 per group) for simulated clinical fixation test, histomorphological observation (to evaluate histocompatibility), and biomechanical property analysis (tensile testing). Results:In the simulated clinical fixation test, the domestically produced abdominal wall segment polylactic acid absorbable microhook urethral sling maintained tight integration with the tissue without detachment across the range of abdominal pressure fluctuations associated with normal human activity (1-34 kPa); in contrast, TVT ABBREVO sling shifted and detached under pressure as low as 15 kPa. At 4 weeks post-implantation in the abdominal wall, none displacement occurred in polylactic acid microhook sling group (0/6 sites), whereas displacement occurred in 5 out of 6 in TVT ABBREVO sling group; at 12 weeks, displacement occurred in 4 out of 24 sites (17%) for polylactic acid microhook sling group, compared to 12 out of 24 sites (50%) for TVT ABBREVO sling group. These differences were statistically significant at both time points (both P<0.01). Tensile testing revealed that the sling of polylactic acid microhook sling group exhibited significantly lower thickness, tensile strength, and elongation percentage after implantation for 12 weeks compared to TVT ABBREVO sling group (all P<0.05). Histocompatibility: both sling types integrated well with host tissues after implantation subcutaneously in the abdominal wall and in the vesicovaginal space. Both induced a mild local inflammatory response. No pathological changes were observed in the surrounding tissues for either sling type, and there were no statistically significant differences in histopathological scores between the two groups (all P>0.05). Conclusions:The domestically produced abdominal wall segment polylactic acid absorbable microhook urethral sling demonstrates favorable histocompatibility. The polylactic acid microhooks significantly enhance the sling′s fixation to the tissue, effectively preventing early postoperative displacement caused by abrupt changes in abdominal pressure, and thus offer superior clinical applicability.

Stress refers to the non-specific responses of a stimulated body to different stressors and the subsequent maintenance or restoration of internal environmental homeostasis.Adverse stress reactions lead to general balance disruption and may cause digestive,neurological,and endocrine disorders,and decreased immune capacity,which seriously impact host health.As the core compo-nent of intestinal micro-ecology,the intestinal flora can greatly alter its own composition,distribu-tion,function,metabolic product output,and other aspects during stress,which cause disorders and aggravate homeostatic imbalance in internal environments.While the intestinal flora is of great sig-nificance to animal medicine and agricultural production,little is known about stress and its impact on intestinal flora.Therefore,we briefly reviewed the impact of stress on animal intestinal flora in combination with the latest research and provided theoretical insights on intestinal health research.

Stress refers to the non-specific responses of a stimulated body to different stressors and the subsequent maintenance or restoration of internal environmental homeostasis.Adverse stress reactions lead to general balance disruption and may cause digestive,neurological,and endocrine disorders,and decreased immune capacity,which seriously impact host health.As the core compo-nent of intestinal micro-ecology,the intestinal flora can greatly alter its own composition,distribu-tion,function,metabolic product output,and other aspects during stress,which cause disorders and aggravate homeostatic imbalance in internal environments.While the intestinal flora is of great sig-nificance to animal medicine and agricultural production,little is known about stress and its impact on intestinal flora.Therefore,we briefly reviewed the impact of stress on animal intestinal flora in combination with the latest research and provided theoretical insights on intestinal health research.

Objective:To evaluate the histocompatibility and biomechanical properties of domestically produced abdominal wall segment polylactic acid absorbable microhook urethral sling in an animal model.Methods:Twenty four rabbits were divided into two groups: polylactic acid microhook sling group ( n=12) and TVT ABBREVO sling group ( n=12). Segments of the slings (abdominal wall portion and urethral portion) were implanted into the rabbit′s abdominal wall and the vesicovaginal space, respectively. Specimens were harvested via euthanasia at postoperative 0 day ( n=3 per group), 4 weeks ( n=3 per group) and 12 weeks ( n=6 per group) for simulated clinical fixation test, histomorphological observation (to evaluate histocompatibility), and biomechanical property analysis (tensile testing). Results:In the simulated clinical fixation test, the domestically produced abdominal wall segment polylactic acid absorbable microhook urethral sling maintained tight integration with the tissue without detachment across the range of abdominal pressure fluctuations associated with normal human activity (1-34 kPa); in contrast, TVT ABBREVO sling shifted and detached under pressure as low as 15 kPa. At 4 weeks post-implantation in the abdominal wall, none displacement occurred in polylactic acid microhook sling group (0/6 sites), whereas displacement occurred in 5 out of 6 in TVT ABBREVO sling group; at 12 weeks, displacement occurred in 4 out of 24 sites (17%) for polylactic acid microhook sling group, compared to 12 out of 24 sites (50%) for TVT ABBREVO sling group. These differences were statistically significant at both time points (both P<0.01). Tensile testing revealed that the sling of polylactic acid microhook sling group exhibited significantly lower thickness, tensile strength, and elongation percentage after implantation for 12 weeks compared to TVT ABBREVO sling group (all P<0.05). Histocompatibility: both sling types integrated well with host tissues after implantation subcutaneously in the abdominal wall and in the vesicovaginal space. Both induced a mild local inflammatory response. No pathological changes were observed in the surrounding tissues for either sling type, and there were no statistically significant differences in histopathological scores between the two groups (all P>0.05). Conclusions:The domestically produced abdominal wall segment polylactic acid absorbable microhook urethral sling demonstrates favorable histocompatibility. The polylactic acid microhooks significantly enhance the sling′s fixation to the tissue, effectively preventing early postoperative displacement caused by abrupt changes in abdominal pressure, and thus offer superior clinical applicability.

Objective:To explore the relationship between the degree of devascularization and clinical outcomes after interventional embolization and sclerotherapy for peripheral arteriovenous malformations.Method:A retrospective analysis was conducted on the data of 37 patients with peripheral arteriovenous malformations admitted at Department of Cardiovascular Surgery, China-Japan Friendship Hospital from July 2021 to June 2023. All patients received the treatment of "nidus" and/or outflow veins embolization combined with sclerotherapy injection. Two experienced physicians evaluated the degree of devascularization before and after treatment, and conducted a correlation study with clinical outcomes after follow-up.Result:All 37 patients were symptomatic. Swelling and pain accounted for 75.7% of all the cases. Twenty-six patients received only one procedure, 3 patients received re-interventional treatments. The average follow-up time was（13.3±5.0）months. Clinical symptoms were completely relieved in 14 patients, and partial relief in 22 patients. The overall effective rate was 97%. There were 6 patients with degree of de vascularization<50% during procedure, 16 patients with degree of 50%-75%, and 5 patients with degree of 75%-90%, 10 cases with degree over 90%. Patients with devascularization degrees less than 60% can not achieve clinical symptom relief.Conclusions:There is a positive correlation between the degree of devascularization and clinical outcomes in the interventional embolization and sclerotherapy of peripheral arteriovenous malformations, and 60% of the degree of devascularization can serve as the "threshold" for effectiveness of treatment.

BACKGROUND:The distribution of the necrotic area plays an important role in hip preservation treatment.At present,there are few studies on whether the difference in the three-dimensional spatial distribution of osteonecrosis of the femoral head affects the clinical outcome of fibular support. OBJECTIVE:To explore the relationship between the spatial distribution and clinical outcome at the sites of osteonecrosis of the femoral head and fibular support using CT three-dimensional reconstruction so as to provide a basis for optimizing the applicable conditions of fibular support and improving the hip preservation effect of fibular support. METHODS:Eighty patients with osteonecrosis of the femoral head who were treated with fibular support for hip preservation from January 2010 to January 2021 were selected as the study subjects according to the inclusion criteria.They were followed up for at least 2 years.According to the clinical outcome,the patients were divided into the successful hip preservation group(n=55)and the failure hip preservation group(n=25).3D reconstruction was performed according to the preoperative and postoperative CT images of the patients.According to the three-column theory,the femoral head was divided into outer nine areas,middle nine areas and inner nine areas(L1-9,C1-9,and M1-9)to explore the spatial distribution of necrotic area of the femoral head and fibular support area and its relationship with clinical outcome. RESULTS AND CONCLUSION:(1)Before operation,the necrotic area of the femoral head was mainly distributed in L1,L2,L4,L5,C1,C2,C4,and C5(the upper and middle part of the anterior part of the outer ninth area and the middle part of the middle ninth area).After operation,the fibular support area was mainly distributed in L5,L6,C5,and C6(the middle and lower part of the outer ninth area and the middle and lower part of the middle ninth area).(2)There were significant differences in the distribution of osteonecrosis of the femoral head between the successful hip preservation group and the failure hip preservation group in L8(the posterior middle part of the outer ninth area),C3(the anterior lower part of the middle ninth area),C6(the lower middle part of the middle part of the inner ninth area)and M2(the anterior middle part of the inner ninth area)(P<0.05).There was a significant difference in the distribution of fibular support in L5 and L6(middle and lower part of outer nine)(P<0.05).Among them,the L8 region could be used as an independent predictor of hip preservation failure in fibular support surgery.The area under the curve of the L8 single factor prediction model was 0.698[95%CI(0.575,0.822)];the sensitivity was 76%,and the specificity was 63.6%.(3)It turns out,when the necrotic area involves L8,C3,C6,and M2,especially L8,the failure of fibular support may increase,and when the fibular support involves L5 and L6,the effect of hip preservation is often not ideal.

BACKGROUND:Bone has bioelectric effects.However,bone defects can lead to loss of endogenous bioelectricity in bone.The implantation of bone tissue engineering scaffolds with bioelectric effect into bone defects will replenish the missing electrical signals and accelerate the repair of bone defects. OBJECTIVE:To introduce the bioelectric effect of bone tissue and expound the repair effect of electrical stimulation on bone defects,summarize the research progress of bioelectric effect applied to bone tissue engineering,in order to provide new ideas for the research of bone tissue engineering. METHODS:Relevant articles were searched on CNKI,WanFang,PubMed,Web of Science and ScienceDirect databases,using"bioelectrical effect,bioelectrical materials,electrical stimulation,bone tissue engineering,bone scaffold,bone defect,bone repair,osteogenesis"as the English and Chinese search terms.Finally,87 articles were included for analysis. RESULTS AND CONCLUSION:(1)Bioelectrical effect combined with ex vivo electrical stimulation to design bone tissue engineering scaffolds is an ideal and feasible approach,and the main materials involved include metallic materials,graphene materials,natural bio-derived materials,and synthetic biomaterial.At present,the most widely used conductive material is graphene material,which benefits from its super conductivity,large specific surface area,good biocompatibility with cells and bones,and excellent mechanical properties.(2)Graphene materials are mainly introduced into the scaffold as modified materials to enhance the conductivity of the overall scaffold,while its large surface area and rich functional groups can promote the loading and release of bioactive substances.(3)However,there are still some major challenges to overcome for bioelectrically effective bone tissue engineering scaffolds:not only electrical conductivity but also the overall performance of the bracket needs to be considered;lack of uniform,standardized preparation of bioelectrically effective bone tissue engineering scaffolds;extracorporeal electrical stimulation intervention systems are not yet mature enough;lack of individualized guidance on stent selection to enable the selection and design of the most appropriate stent for patients with different pathologies.(4)When designing conductive scaffolds,researchers have to deeply consider the comprehensive effects of the scaffolds,such as biocompatibility,mechanical properties,and biodegradability.This combination of properties can be achieved by combining multiple materials.(5)Beyond that,clinical translation should be the ultimate consideration for conductive stent design.On the basis of evaluating the safe current threshold for electrical stimulation to act on the human body and facilitate the repair of bone defects,animal experiments as well as basic experiments are designed and then applied to the clinic to achieve the ultimate goal of applying bioelectrical effect bone tissue engineering scaffolds in the clinic.

Objective: To study the effect of a space stabilizing device on the capacity for osteogenesis in the bone-grafted area. Methods: Patients with anterior teeth defects as well as labial alveolar ridge defects were randomly divided into two groups: the experimental group was treated using a space stabilization device after guided bone regeneration whereas the control group received regular guided bone regeneration. The CBCT data was analyzed prior to, immediately and 6 months after procedure to compare the osteogenesis with or without the device. Results: Seventeen bone-grafted sites were examined(7 in the experimental group and 10 in the control group). At 2 mm and 4 mm below the alveolar ridge, the horizontal bone resorption rate in the experimental group was significantly lower than the corresponding level in the control group(P=0.001). The horizontal bone resorption rate at 2 mm below the alveolar ridge of each group was significantly higher than that at 4 mm below the alveolar ridge in corresponding groups(P=0.003). Conclusion The space stabilizing device used in this study has a positive clinical impact on preserving space stability and minimizing bone resorption.